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Final 18-Month Results Volume 4 January 2019 FINAL 18-MONTH RESULTS 1 “WE MUST REMEMBER THAT ONE MAN IS MUCH THE SAME AS ANOTHER, AND THAT HE IS BEST WHO IS TRAINED IN THE SEVEREST SCHOOL.” – THUCYDIDES 2 TABLE OF CONTENTS 1 Executive Summary 5 Assessment Of Data/Program Evaluation 8 Outcomes Of 18-Month Program Evaluation 10 18-Month Program Evaluation Report The PATHH To Posttraumatic Growth: 17 Warrior PATHH Students Share Their Stories 23 Military Psychologist Article 30 18-Month Results 58 Qualitative Feedback Contact information: Josh Goldberg 33735 Snickersville Turnpike Bluemont, VA 20135 (972) 975-7488 [email protected] www.bouldercrestinstitute.org EXECUTIVE SUMMARY Since the attacks of September 11, 2001, more than 2.8 million men and women have deployed to war zones across the globe, serving with honor, courage, commitment, loyalty, duty, respect, integrity, and excellence. The post 9/11 conflicts, which represent the longest stretch of war in American history, have taken a tremendous toll in terms of both visible and invisible wounds. It is estimated that more than 30 percent of these remarkable Warriors are struggling with PTSD (a clinical diagnosis received from a mental health professional) or combat stress (struggling with the same symptoms but lacking an official diagnosis). We have now lost more brave souls to suicide at home than on the battlefield, and the suicide rate has grown every year since 2002. In September 2013, we opened Boulder Crest Retreat Virginia with one objective in mind – to ensure that combat veterans and their families had what they required to live great lives – full of passion, purpose, growth, connection, and service – here at home. Our first nine months were dedicated to learning and understanding the nature and effectiveness of current approaches, and identifying gaps. We hosted a number of clinical and non-clinical programs, attended conferences, and had countless meetings with experts from across the trauma, PTSD, and military psychology fields. What we heard – time and again – was that nothing was working. Nothing was allowing combat veterans to thrive at home. The treatments they did receive – normally a combination of pharmacology and psychotherapy – seemed to temporarily diminish some of the more overwhelming symptoms of PTSD and combat stress, but could not offer a springboard to a great life at home. In short, the message was clear: the best that struggling combat veterans and their family members could hope for was lives as diminished, and often medicated, versions of themselves. Beginning in May 2014, we began work on a new and innovative program – Warrior PATHH – to address the shortcomings of the status quo and ensure that combat veterans could thrive at home. Warrior PATHH represented the first-ever program designed to cultivate and facilitate Posttraumatic Growth (PTG) amongst the military and veteran community. PTG is a decades- old science that provides a framework for transforming times of deep struggle into profound strength and lifelong growth. “BOULDER CREST RETREAT ACTS AS A LABORATORY FOR EXPLORING THE EFFECTIVENESS OF ALTERNATIVE APPROACHES TO HELPING VETERANS AND THEIR FAMILIES ACHIEVE POSTTRAUMATIC GROWTH.” DR. RICHARD TEDESCHI AND DR. BRET MOORE, THE MILITARY PSYCHOLOGIST, 2016 1 After more than four years of hard work on Warrior PATHH, five things are clear: 1. The current approach to mental health is not working. These are not our words, but the expert opinions of luminaries from the mental health community. Dr. Thomas Insel, former director of the National Institute of Mental Health, recently asked, “Are we somehow causing increased morbidity and mortality with our interventions?” In August 2015, The Journal of the American Medical Association (JAMA) declared that “new innovative and engaging approaches for the treatment of PTSD are needed.” These words were echoed in the January 2017 edition of JAMA Psychiatry, which stated that “These findings point to the ongoing crisis in PTSD care for service members and veterans. Despite the large increase in availability of evidence-based treatments, considerable room exists for improvement in treatment efficacy, and satisfaction appears bleak based on low treatment retention…we have probably come as far as we can with current dominant clinical approaches.” ”WE HAVE PROBABLY COME AS FAR AS WE CAN WITH CURRENT DOMINANT CLINICAL APPROACHES.” JAMA PSYCHIATRY, 2017 2. The struggles that combat veterans experience in the aftermath of war often relate far more to what they are coming home to (society and peace) than what they are coming home from (war). The same training that ensures Warriors thrive on the battlefield can become problematic on the home front. In order to address this challenge, combat veterans require TRAINING to learn how to translate their valuable skills at home and regain the capacity to regulate their thoughts, feelings, and actions. 3. Combat veterans represent the strongest and finest among us. These Warriors possess skills, strengths, and abilities that are seldom seen and desperately needed here at home. This notion is best captured in the words of Thucydides, an Athenian General and historian, who famously wrote the History of the Peloponnesian War: “We must remember that one man is much the same as another, and that he is best who is trained in the severest school.” 4. When we provide combat veterans with the opportunity to take a knee and receive training that allows them to harness their strengths and abilities at home, they can live the great lives they deserve – full of passion, purpose, and service. 5. Times of deep struggle, and even despair, can serve as the gateway to a life that is authentic, fulfilling, and purposeful. This idea – that what does not kill you can in fact make you stronger – is the basis of Warrior PATHH, and is derived from the science known as Posttraumatic Growth (PTG). 2 In 2015, two world-class psychologists – Dr. Richard Tedeschi and Dr. Bret Moore – agreed to evaluate Warrior PATHH. The two psychologists reported that the progress they were witnessing was unheard of, and began reflecting on how to assess the effectiveness of the program with a view towards ensuring it could become an evidence-based standard. “IN JUST TWO DAYS, PATHH MAKES BREAKTHROUGHS THAT WOULD TAKE THE AVERAGE MEDICAL MODEL 12-14 MONTHS.” DR. BRET MOORE, TWICE-DEPLOYED FORMER ARMY PSYCHOLOGIST Given their observations, and in particular Dr. Moore’s statement that: “In just two days, PATHH makes breakthroughs that would take the average medical model 12-14 months,” the next step was clear: we must develop the nation’s first-ever curriculum designed to cultivate and facilitate Posttraumatic Growth amongst combat veterans. This curriculum would enable Warrior PATHH to be codified, documented, proven, and most significantly, scaled to help combat veterans from across the country and possibly the world. In January 2016, the Marcus Foundation invested $1.05 million to make this vision a reality. This investment focused on two areas of work: the development of the curriculum, inclusive of the Warrior PATHH Instructor Guide, Warrior PATHH Student Guide, Warrior PATHH Journal, Warrior PATHH Syllabus, and Warrior PATHH Schedule of Events; and an 18-month program evaluation of four pilot programs, conducted by Drs. Tedeschi and Moore, to assess the effectiveness and impact of Warrior PATHH. The 18-month program evaluation is now complete, and the results provide quantitative evidence of what we know to be qualitatively true: Warrior PATHH doesn’t only reduce symptoms substantially; it enables students to live the great lives they deserve here at home. Warrior PATHH unlocks the value of military training and combat experience, and allows combat veterans to be the calm, connected, and congruent leaders desperately needed in their families, communities, and country. At the heart of what makes Warrior PATHH successful and differentiates the program from the status quo approaches is best reflected in the words of Goethe: “If we treat people as they are, we make them worse. If we treat people as they ought to be, we help them become what they are capable of becoming.” 3 “IF WE TREAT PEOPLE AS THEY ARE, WE MAKE THEM WORSE. IF WE TREAT PEOPLE AS THEY OUGHT TO BE, WE HELP THEM BECOME WHAT THEY ARE CAPABLE OF BECOMING.” GOETHE This report was created to share the results of the 18-month program evaluation, and in the hopes of catalyzing a discussion about our current mainstream PTSD treatments. It is clear from our experiences and successes, the articles in the Journal of the American Medical Association publications, and the words of combat veterans that we need a new, innovative, and effective approach that allows people to thrive, not simply survive. Warrior PATHH is that new approach – and the pages that follow demonstrate precisely why that is true. When we send men and women to war, we make a special covenant with them. In exchange for their service and sacrifice, we pledge to bring them home – all the way home. As a society, we are failing to honor that commitment. We can and must do better. We must never forget that combat veterans possess strengths, skills, and abilities that are seldom seen and desperately needed here at home. It is our responsibility to understand how to harness those strengths and abilities, and enable this remarkable community of heroes to be as productive at home as they were on the battlefield. That is why we created Warrior PATHH, why we acquired Boulder Crest Retreat Arizona in May 2017, why we are supporting efforts to implement Warrior PATHH in communities across the country, and why we are inviting you to join us. Together, we can unlock the potential of America’s Next Greatest Generation. Josh Goldberg Co-Founder and Executive Director Boulder Crest Institute for Posttraumatic Growth Author, Struggle Well [email protected] 4 ASSESSMENT OF DATA/PROGRAM EVALUATION Dr.
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